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Biomedical subjects

C Pleşa

Publications and source records attributed to C Pleşa.

At least 19 recordsLinked to original sources
PubMedDate not supplied

[Adenocarcinoma in Barrett esophagus: its recurrence and long-term survival].

Adenocarcinoma arising in ectopic gastric mucosa has been reported more than 40 years ago. This report reviews our experience with Barrett's adenocarcinoma over 8 years. The definition remains subject to controversy. More than 50% of patients in our study had unfavorable course of disease. The hope for cure lies almost in early detection of tumors at which point a truly curative resection could be done. There is no difference in terms of survival comparing to the adenocarcinoma arising on normal esophagus.

Adenocarcinoma↗
PubMedDate not supplied

[Klatskin's tumor].

During the period 1989-1998, 27 patients with primary proximal bile duct cancer were treated (17 females and 10 males with a mean age of 61 years). The main presenting symptoms were: jaundice (96.2%), itching (92.5%), weight loss (74%) and atypical pain (33.3%). All the patients underwent ultrasound (US) examination, 7 patients endoscopic retrograde cholangiopancreatography (ERCP) and 4 patients computed tomography (CT) examination. US examination revealed the tumor in 51% cases; most frequently a dilatation of the intrahepatic bile ducts was diagnosed with all methods. 8 patients underwent resection of the tumor and one a biliary-enteric anastomosis, in 15 cases a stent was inserted. In 3 cases the extension of the malignancy did not allowed any procedure. Three patients died during immediate postoperative period (mortality 11.2%). The mean survival was 13 months after stenting and 22 months after resection of the tumor. The authors recommended an aggressive surgical therapy for Klatskin tumors.

Adult↗
PubMedDate not supplied

[Incisional hernias after operative laparoscopy].

The objective of this study was to determine the possible risk factors of incisional hernias after operative laparoscopy. Complications involving the abdominal wall, particularly incisional hernias, were not expected when laparoscopic procedures were first introduced. With the increasing number of laparoscopies in the abdominal surgery, more incisional hernias were observed. Of the approximately 3,145 patients who underwent laparoscopy from march 1993 through march 2000 in the First Surgical Clinic Iassy, a total of 15 hernias occurred, which is an incidence of 0.477%. There were no acute complications, such as small bowel obstruction, secondary to herniation through the trocars. Risk factors such as chronic bronchitis or weight increase, which give rise to abdominal pressure, were present in some cases. Precautions such as fascial suturing must be taken to reduce the incidence of this minor complication of laparoscopic surgery.

Adult↗
PubMedDate not supplied

[Laparoscopic cholecystectomy in non-lithiasis cholecystopathies].

We made a study in 1st Surgery Clinic of Iassy between March 93--November 98, with 2246 laparoscopic cholecystectomies. The reason was to define the place and role of laparoscopy in non-lithiasis cholecystopathies (81 cases). In the same period were operated classically 888 calculous cholecystitis and 38 non-lithiasis cholecystitis. The laparoscopy has a major role in diagnosis to the patients with many abdominal symptoms. We discovered pericholecystic adherences, hepatic cirrhosis, acute appendicitis, etc. Sometimes, the laparoscopy was made for "second look" after surgical treatment for neoplasia, the metastasis diagnosis, for tumors visible echographically. In many situations the laparoscopic cholecystectomy may be considered like a preventive operation. The easy postoperative evolution is an argument to enlarge the indication for laparoscopic cholecystectomy in alithiasis cholecystitis.

Cholecystectomy, Laparoscopic↗
PubMedDate not supplied

[Cephalic duodenopancreatectomy with pyloric preservation in the treatment of pancreatic cancer].

UNLABELLED: Is the application of DPCPP in the treatment of pancreatic neoplasia a good reason? We have analysed 30 patients with cephalic duodenopancreatectomy (DPC) for biliopancreatic neoplasia between 1995-1999 in Ist Surgical Clinic of Iassy (13 with pyloric preservation). The indications were:--cephalic pancreatic neoplasia (adenocarcinoma--4 cases (one with cephalic chronic pancreatitis on the intraoperative microscopical examination);--Vater ampulloma (7 cases);--inferior common biliary duct (CBD 1 case);--duodenal adenocarcinoma (1 case). In the same time was operated 265 biliopancreatic diseases (203 mechanical jaundice with 132 neoplastic jaundice). RESULTS: --Better early postoperatively status of the patients--DPCPP does not give better prognosis;--there are necessary some technical skills to depase the important phases of DPCPP.

Adenocarcinoma↗
PubMedDate not supplied

[ Etiopathogenesis of autoimmune thyroiditis].

Human autoimmune thyroid diseases include both autoimmune hypothyroidism (thyroiditis) and autoimmune hyperthyroidism (Graves' disease). Either of the two feature profuse thyroidal infiltrates of CD4+ and CD8+ T-cells and a biased intrathyroidal T-cell-receptor repertoire. Despite strong epidemiologic evidence in favor of a genetic component in the etiology of autoimmune thyroiditis, few hereditary risk factors have been consistently identified, which include a well-characterized series of HLA genes. These may account for the progression from a harmless autoimmune response characterized solely by production of autoantibodies to thyroglobulin to pathogenic autoimmunity where injury occurs to the thyroid cells. We hereafter summarize the role of inherited risk factors along with that of environmental risk factors. It was suggested that iodine increase the autoantigenic potency of thyroglobulin, a major pathogenic antigen in the induction of autoimmune thyroiditis. The clinical entities included together as autoimmune thyroiditis is shortly reviewed, along with the presentation of the common pathogenetic pathways. Unique features of each member of the group are further emphasized.

CD4-Positive T-Lymphocytes↗
PubMedDate not supplied

[Stapled esophago-jejunal anastomosis after total gastrectomy in gastric neoplasm].

A number of 1031 patients with gastric cancer have been admitted in the First Surgical Clinic of Iasi between 1986-2001. The operability index was 86%, 52% being resectable and 36% having potential curative resection. In this group, 222 patients benefited from total gastrectomies. We consider the introduction of stapled eso-jejunal anastomosis (38 patients) as the most important moment in this development, as the manual performance anastomosis is considered difficult due to the problems imposed by suturing in a deep space. Postoperative course of patients who benefited from stapled anastomosis was simple although many patients had a poor biological status. We encountered only one small fistula, which was dealt with conservative. Patients in this group had immediate postoperative results significantly better than the comparative group with manually performed anastomosis. Introduction of stapler techniques increased the proportions of patients who benefited from palative total gastrectomies for advanced gastric cancer. We consider that a method to solve the frequent complications, insured an increased intraoperative comfort, reduced the number of postoperative complications, increased survival and improved patients quality of life.

Adult↗
PubMedDate not supplied

[Giant retroperitoneal lipoma].

70 retroperitoneal tumors (10 with an adipous origin out of which 8 were lipomas) have been operated upon in our clinic since 1985. Four cases of giant lipomas are presented in this paper. They weighed 4.5-7.5 kg. and had a diameter over 15 centimeters. Their close proximity with the kidney, duodenum, colon, inferior vena cava etc made there extirpate difficult. The post-operative condition of the patients was good. Although the histopathological tests proved that all these giant lipomas were benign after two to four years, their relapse required a new surgical intervention. The histopathology of the relapsed lipomas revealed a malign degeneration in 3 out of the four cases. The origin of this malign degeneration was in the fibrous part of the tumors.

Female↗
PubMedDate not supplied

[Zenker's diverticulum--surgical management in a series of six cases].

Zenker's diverticulum is a protrusion of the posterior mucosal wall of the hypopharynx through the weakened muscular layer, between the oblique fibers of the inferior constrictor of the pharynx and the transverse fibers of the cricopharyngeal muscle (Killian's dehiscence). Pharyngoesophageal pulsion diverticulum is the most common of all the oesophageal diverticuli and is characterised by dysphagia, regurgitation, gurling sounds in the neck and aspiration. The current principles of surgical management includes a pharyngoesophageal myotomy accompanied by a diverticulectomy or a diverticulopexy. The same principles apply in both open approach and the endoscopic methods.

Aged↗
PubMedDate not supplied

[The diagnosis and treatment of benign tumors of the subdiaphragmatic digestive tract].

One hundred twenty-two benign tumors of subdiaphragmatic digestive tract admitted in the interval 1975-1988 at the III-rd Surgical Clinic of Iaşi are reported. Out of these patients 120 required surgical treatment, the remainder of 2 being treated conservatively (diffuse intestinal angiomatosis, Peutz-Jeghers' syndrome). The clinical evolution being atypical, the surgical intervention was required, in most of the cases, due to hemorrhagic and occlusive complications. Histologically, the polyps and schwannomas were prevalent. The diagnostic difficulties, especially in the cases with jejuno-ileal localization, are mentioned.

Diaphragm↗
PubMedDate not supplied

[The clinical, diagnostic and therapeutic characteristics in antral gastric cancer].

This paper is part of a comprehensive study on subphrenic digestive cancer carried out between 1984 and 1988, representing the experience of the III-rd, I-st, IV-th and emergency surgical clinics of Iaşi (1530 cases). The peculiarities of gastric cancer with antral site in 231 out of a total of 612 cases, representing the experience of the III-rd Surgical Clinic, are presented. Clinically, the relative early occurrence of the symptoms, the need for an endoscopic examination and biopsy for all gastric ulcer lesions, for the antral ones particularly, are mentioned. The treatment is surgical, but it has to be associated with adjuvant therapy. For the antral site, the oncological subtotal gastrectomy was the surgery of choice (157 cases), the need of restoring the transit in a gastrojejunal manner being underlined. Total gastrectomy was performed in 12 cases.

Combined Modality Therapy↗
PubMedDate not supplied

[Antireflux surgery in the treatment of peptic esophagitis].

This paper deals with the outcome of the various "antireflux" surgical procedures performed in 21 patients having esophagitis. Immediate and long-lasting results are better for those methods which restore the gastroesophageal competence: Hill's operation (4) and Nissen's fundoplication (3). The participation of the stomach in producing reflux is stressed and is emphasized the necessity to treat the gastric lesions simultaneously. The duodenal diversion following Harrington procedure offers good results with minimal surgical risk in some particular cases.

Adult↗